Restoring normal function to the body is the crux of recuperation. Bowel function is less active than usual for a day or so after hysterectomy due to the effects of the anaesthetic and the handling of internal organs during surgery. For this reason, food is vetoed and fluids are restricted for anything up to twenty-four hours after surgery. In order to provide adequate nourishment during this time an intravenous drip is connected to a vein in the arm. Once bowel activity starts — and this is helped by getting up and moving around — fluid intake can be increased and light meals started. Many women experience distress at this time due to large amounts of ‘wind’ and colicky pain which usually last for one to three days. Strategies to overcome these side-effects include pain relief which may come in tablet form or, in severe cases, injections. Some pain killers, such as codeine, are best avoided because they can cause constipation. Charcoal tablets, which absorb gas in the bowel, can alleviate this problem very effectively. A mild laxative is often found helpful or, if difficulty persists, a suppository. Strong laxatives and enemas may be used when there is a prolonged delay in bowel emptying, particularly if this is associated with colic. It is not unusual for bowel function to take several months to return to normal after hysterectomy.
On rare occasions, the bowel may be paralysed for several days after surgery. Eating will stretch the paralysed bowel and cause further delays in recovery of bowel function. So an intravenous drip is needed to supply nutritional needs in the meantime. Another rare occurrence is bowel blockage caused by the formation of adhesions during the operation. The blockage may resolve if the bowel is rested, but if not, further surgery is required. Although this is an unusual and unpleasant complication, the outcome is generally quite satisfactory.
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